EXHALED NITRIC-OXIDE AND BRONCHOALVEOLAR LAVAGE NITRITE NITRATE IN ACTIVE PULMONARY SARCOIDOSIS/

Increased exhaled nitric oxide (NO) may reflect respiratory tract infl ammation in untreated asthmatics. We compared exhaled NO and bronchoal veolar lavage (BAL) nitrate/nitrite (NO3-/NO2-) in 10 patients who had untreated, active pulmonary sarcoidosis with those of normal control subjects. Exhaled NO concentrations, determined by chemiluminescence, were similar in patients and control subjects (peak NO concentration o f patients [mean +/- SD]: 13.6 +/- 5.9 parts per billion [ppb], peak N O concentration of control subjects: 11.2 +/- 5.7 ppb, p = 0.32; mean alveolar NO concentration of patients: 7.8 +/- 4.4 ppb, mean alveolar NO concentration of control subjects: 7.1 +/- 4.2 ppb, p = 0.70; end-t idal NO concentration of patients: 6.9 +/- 4.5 ppb, end-tidal NO conce ntration of control subjects: 6.6 +/- 4.0 ppb, p = 0.60). BAL NO2- was assayed using a modified Griess reaction after reduction of NO3- to N O2-. There was no significant difference in mean BAL NO2- concentratio ns, expressed as nanomoles per milliliter of epithelial lining fluid ( patients: 544 nmol/ml, control subjects: 579 nmol/ml, p = 0.81) or as nanomoles per milliliter of BAL fluid (patients: 6.7 nmol/ml, control subjects: 5.7 nmol/ml, p = 0.41). These data suggest that excess NO ge neration does not accompany the respiratory tract inflammation of pulm onary sarcoidosis.